Key result
Lower baseline systemic inflammation and chloride link to better nutritional recovery in anorexia nervosa.
Why the study?
Malnutrition and starvation in anorexia nervosa lead to impairments in metabolic processes, hormonal regulation, and immune function that may offer diagnostic and prognostic value regarding treatment response and nutritional rehabilitation.
Do baseline immune-metabolic-hormonal biomarkers predict treatment response to nutritional rehabilitation in hospitalized females with anorexia nervosa?
Cohort (n=50)
No
Do baseline immune-metabolic-hormonal biomarkers predict treatment response to nutritional rehabilitation in hospitalized females with anorexia nervosa?
Baseline inflammatory and metabolic biomarkers, particularly SIRI and chloride, may serve as valuable early predictors of nutritional recovery in hospitalized patients with anorexia nervosa.
Answers are grounded in this paper and cite their sources.
May support early prediction of nutritional recovery by baseline SIRI and chloride in anorexia nervosa; leaves open prospective validation before clinical use.
Background/Objectives: Anorexia nervosa (AN) is a chronic eating disorder with the highest mortality rate among psychiatric conditions. Malnutrition and starvation lead to long-term impairments in metabolic processes, hormonal regulation, and immune function, offering potential diagnostic and prognostic value. This study aimed to identify immune–metabolic–hormonal markers associated with treatment response and nutritional rehabilitation. Methods: Fifty hospitalized female patients with AN were included. Anthropometric measurements and venous blood samples were collected at admission and discharge, following partial nutritional recovery. Blood analyses included complete blood count, serum levels of total cholesterol, LDL and HDL, triglycerides, glucose, NT-pro-BNP, TSH, free thyroxine (fT4), sodium, chloride, potassium, calcium, iron, and vitamin D. Composite immune-inflammatory indices calculated were neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR); neutrophil-to-high-density lipoprotein (NHR), monocyte-to-high-density lipoprotein (MHR), platelet-to-high-density lipoprotein (PHR) and lymphocyte-to-high-density lipoprotein (LHR) ratios; systemic immune-inflammation (SII), and systemic inflammation response (SIRI) indexes. Results: Responders (R) and non-responders (NR) differed significantly at baseline in levels of sodium, chloride, fT4, monocyte count, MCV, NLR, MLR, SII, and SIRI (all: R < NR; p < 0.05). Predictive ability for treatment response was confirmed by AUC values (95%CI): sodium = 0.791 (0.622–0.960), chloride = 0.820 (0.690–0.950), fT4 = 0.781 (0.591–0.972), monocytes = 0.785 (0.643–0.927), MCV = 0.721 (0.549–0.892), NLR = 0.745 (0.578–0.913), MLR = 0.785 (0.643–0.927), SII = 0.736 (0.562–0.911), SIRI = 0.803 (0.671–0.935). The lower levels of inflammation and chloride are particularly predictive of better nutritional recovery, accounting for 26% of the variability in treatment response. Conclusions: The study demonstrated important insights into the hematological, metabolic, hormonal, and immune-inflammatory mechanisms associated with nutritional recovery in AN.
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Róg et al. (2025) conducted a cohort in Anorexia Nervosa (n=50). Baseline hematological, immune-inflammatory, and metabolic biomarkers (e.g., SIRI, chloride) vs. Low vs. high biomarker levels was evaluated on Treatment response (nutritional recovery defined as BMI increase ≥1.5 kg/m²) predicted by Systemic Inflammation Response Index (SIRI) (AUC 0.803, 95% CI 0.671-0.935, p=<0.05). Lower baseline levels of systemic inflammation (SIRI) and chloride predicted better nutritional recovery, accounting for 26% of the variability in treatment response among hospitalized females with anorexia nervosa.
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